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Extensive bone loss necessitates a skeletal reconstruction with a tumour prosthesis, usually treated in a centre with specialist revision surgeons, specialist microbiologists and plastic surgeons.
All revisions were performed by or under the direct supervision of 4 experienced hip revision surgeons.
This may be because revision surgeons were often not responsible for and/or from units remote to the primary procedure.
All patients in our cohort were operated by 2 experienced hip revision surgeons who decided upon implant size intraoperatively, based on proper fit and stability.
We operate a multi-disciplinary team (MDT) meeting consisting of an expert panel of hip revision surgeons and musculoskeletal radiologists who meet on a weekly basis to discuss the management of patients with MOM hip implants.
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The date of the primary procedure was frequently missing (five of 49 cases (10.2%)) due to this not being supplied by the revision surgeon.
Discrepancies in the recording of the date of the primary procedure are also likely to lie with the RC, given that referrals are from the revision surgeon, as discussed above.
During revision, the surgeon observed metallosis around the hip joint, but no cystic or solid masses.
Dealing with loss of bone stock is one of the greatest challenges facing the revision hip surgeon.
The revision rate for surgeons with a 10% usage or less is very high.
In more complex primary or revision cases, some surgeons perform an osteotomy for better exposure of the hip; i.e. the existing anatomy can be prepared more adequately and the components can be removed and placed more precisely [ 1, 2].
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